Leukoplakia

(Hairy Leukoplakia; Smoker’s Keratosis)

Definition

Leukoplakia is a disorder of the mouth’s mucus membranes. White patches form on the tongue or inside of the mouth over weeks or months. This can also occur on the vulva in females, but for unknown reasons. One type, known as hairy leukoplakia, is a type found primarily in people who have HIV or other types of severe immune deficiency.

Causes

Hairy leukoplakia results from infection with the Epstein-Barr virus.Leukoplakia usually results from irritants, such as:
  • Pipe or cigarette smoking
  • Chewing tobacco or snuff
  • Rough teeth
  • Rough places on dentures, fillings, or crowns

Risk Factors

Leukoplakia is more common in men after age 65. Other factors that may increase your chance of developing leukoplakia include:
  • Lifestyle:
    • Tobacco use, especially smokeless tobacco
    • Long-time alcohol use
  • Having a weakened immune system such as from HIV
In women, the condition often develops into cancer.

Symptoms

Leukoplakia may cause:
  • Lesions on the tongue or gums, inside of the cheeks, or on the vulva that is:
    • White, gray, or red in color
    • Thick, slightly raised, or hardened on the surface
  • Sensitivity to touch, heat, or spicy foods
  • Pain or other signs of infection
  • Hairy leukoplakia is painless, with a fuzzy, white appearance
In some cases, leukoplakia looks like oral thrush, which is an infection also associated with HIV infection and lowered immune function.
Oral Thrush—Resembles Leukoplakia
Thrush
Copyright © Nucleus Medical Media, Inc.

Diagnosis

In most cases, a dentist can diagnose leukoplakia with a mouth exam. To confirm a diagnosis or to check for cancer, an oral brush biopsy may be needed. This involves removing some cells with a small brush. It takes only minutes and is painless. A pathologist then checks these cells for signs of cancer. Sometimes the dentist or oral surgeon uses a scalpel to remove cells after numbing the area.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:
  • Removing the irritant—Quitting smoking or correcting dental problems often takes care of the problem.
  • Removing patches—If the problem persists, or if signs of cancer are present, your dentist or doctor may need to remove patches of leukoplakia.
  • Taking medication—For hairy leukoplakia, the doctor may prescribe antiviral medications, or a solution to apply to the skin.

Prevention

To help reduce your chance of getting leukoplakia:
  • If you smoke, talk to your doctor about how you can successfully quit.
  • Avoid or limit your use of alcohol.
  • See a dentist regularly, especially if you have rough places in your mouth.

RESOURCES

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

National Institute of Dental and Craniofacial Research
http://www.nidcr.nih.gov

CANADIAN RESOURCES

Canadian Dental Association
http://www.cda-adc.ca

Canadian Dental Hygienists Association
http://www.cdha.ca

References

Epstein-Barr virus (EBV) infection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 13, 2014. Accessed August 14, 2014.

Hairy leukoplakia. DermNet NZ website. Available at: http://dermnetnz.org/site-age-specific/hairy-leukoplakia.html. Updated December 29, 2013. Accessed August 14, 2014.

Oral hairy leukoplakia. AETC National Resource Center website. Available at: http://aidsetc.org/guide/oral-hairy-leukoplakia. Published April 2014. Accessed August 14, 2014.

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